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PERMIT EXPIRES
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PERMIT
CITY OF EDMONDS
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NUMBER
CONSTRUCTION PERMIT APPLICATION
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DATE
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PER USC 1081FINAL INSPECTION REO�D
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Description
FEE
Description
FEE
Plan Check
P I
State Surcharge
HEAT SOURCE No LOT SLOPE %
Building Permit
City Surcharge
PLANCHECK:L VESTED DATE
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Plumbing
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Mechanical
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THIS PERMIT AUTHORIZES ONLYTHE W08K NOTED. THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONST UCTIONONTHEPUBUC
Grading
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3 DOMAIN (ouress, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATEPEAMISSION.
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Engr. Rendeav
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I PE ITAPPLICATION: I -DAYS
PERMIT Leang I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
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Engr. Inspection
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
IPPLIC ON BEHALF 01 HIS OR HER SPOUSE, Helps, ASSIGNS AND IUCCE1011
AHT
Fire Revie.
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND All. HOLD HARMLESS THE CITY .1
Receipt #
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND
ALL CLAIMS 101 DAMAGES 01 WHATEVER NATURE, ARISING 131HIC11Y OR INJM��CTLY
Fire Inspection
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscape Insp.
Total Amt. Due
CE
DEEMED TO MODIFY. WAIVE OR SEDUCE ANY REQUIREMENT OF ANY CITY ORDIN,NNG:
NOR LIMIT IN ANY WAY THE CRYS ABILITY TO ENFORCE A. OfMINAN.. 1PONIS1.1,L'
Recording Fee
Receipt III
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS COARECE AND THAT I AM THE OWNER OR THE DULY AUTHORIZED AGENT OF
nei.ppli.aftris... p.naft unfil signed by in.
OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
THE C HST.L.
PERSON WILL BE EMPLOYED
CALL
Sending OffiCial Of I or apaty: and Fees are paid, a
ITO N; AND IN DOING THE WORK AUTHORIZED THEREBY, NO
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
kisind
FOR INSPECTION N,c,ipi 1, ac edged In specoinevid,di.
WORKMENS COMPENSATION,INSURANCE AND RCW 18,27.
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OFFIC L IGNAT E
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(425)
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771-0220
RILE ,,4ATE
ATTENTION
Off 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
'3C
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
OR GINAL - FILE ELLOA? - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
P-NK-OWNER GO 0 -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN ACCOUNTING
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RECORD OF INSPECTIONS
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INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing . .....................
Wall .........................
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Pier/Porch ............
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petaining Wall
Slab Insulation ..........
PLUMBING:
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Rough -in .............
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Commercial Final
HEATING:
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Gas Test ..........
Gas Piping .................
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Equipment .................
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Commercial Final
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EXTERIOR SHEATHING
NAILING ............
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FRAMING :... ...................
FIRST FLOOR FRAMING
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INSULATION ...............
Floor Insulation
Wall Insulation
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Coiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY .................. VYIS